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52 Cards in this Set
- Front
- Back
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What do central veins empty into?
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hepatic veins which empty into the IVC
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What is the lobule composed of?
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cellular plates with hepatocytes radiating like spokes from the central vein
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What lies between hepatocytes?
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canaliucli
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What is another name for kupffer cells?
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reticuloendothelial cells
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what lies between hepatocytes and endothelial cells?
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space of disse
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what is another name for the space of disse?
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perisinusoidal space
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What do the spaces of disse drain to?
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lymph system
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What is the flow rate of blood through the portal vein?
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1L/min
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What is the flow rate of blood through the hepatic artery?
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300mL/min
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What is the percentage of cardiac output that goes to the liver?
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~25%
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what is another name for the space of disse?
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perisinusoidal space
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What do the spaces of disse drain to?
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lymph system
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What is the flow rate of blood through the portal vein?
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1L/min
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What is the flow rate of blood through the hepatic artery?
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300mL/min
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What is the percentage of cardiac output that goes to the liver?
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~25%
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the blood pressure in the portal vein is 15mmHg. Is this high?
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yes, portal pressure is 9mmHg
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If someone has a pressure of 2mmHg in the hepatic vein is this low?
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No this is hi, it is generally 0
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Given that portal pressure is 9mmHg and hepatic vein is 0mmHg what does this signify about blood flow?
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That there is low resistance in the liver
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What does cirrhosis do to blood flow through the liver?
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increases resistance elevating the portal pressure. Pressures rise to 15-20mmHg above normal. This causes loss of fluid from capillaries into lumens and walls of intestines
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How much blood can the liver store in the hepatic sinuses?
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450 mL
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In what condition will the liver be forced to act as a reservoir and store extra blood?
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CHF
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When IVC pressure rises by 10-15mmHg what results?
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fluid transudes from the lymphatic vessels of the outer surface of the liver resulting in ascites
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How much of the liver can be removed and the organ still regenerate?
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70%
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What hormone is responsible for hepatocyte growth stimulation after liver resection?
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hepatocyte growth factor produced in mesenchymal liver cells and cells outside the liver
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What is the main hormone involved in liver cell growth inhibition?
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TGF-beta
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What determines the size of the liver?
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The liver to body ratio for optimal metabolic function
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What organ besides the liver can deaminate amino acids
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kidney
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Where is a large amount of ammonia produced besides in the liver?
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colonic bacteria produce ammonia and then it is absorbed
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If the liver is producing protein at 10 g/day what will the plasma be?
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hypotonic. normal protein synthesis by liver is 15-50 g/day
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What factor stimulates hepatic cell growth other than hormonal?
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plasma protein concentration
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What vitamins are stored in high concentrations in the liver?
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vitamin A, D, B12
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If someone has an apparent vitamin A deficiency how long can you assume that they have not been taking enough vitamin A in their diet?
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the liver can store vitamin A for 10 months then symptoms of vitamin A deficiency show
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If a resident had not seen the sun in the past 2 months would he be vitamin D deficient?
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No the liver can store enough vitamin D for 3 to 4 months
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How long does it take someone to develop pernicous anemia?
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longer than a year because the liver stores a surplus of B12
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How is iron stored in the liver?
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in ferritin
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What is apoferritin?
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a protein that binds free iron to form ferritin
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Give examples of hromones that are modified in the liver?
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thyroxine, steroid hormones
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How is calcium primarily lost from the body?
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in the bile via liver production
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Describe the hemoglobin degradation process?
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1)Hgb is split into globin and heme.
2) the heme ring is opened which releases iron which is taken up by transferrin 3) the pyrrole nuclei are formed into biliverdin and reduced to free bilirubin 4) bilibrubin is coupled to albumin and transported to the liver |
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What is the main site of hemoglobin degradation?
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spleen
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What is the major form of bilirubin conjugation?
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bilirubin glucuronide 80%
bilirubin sulfate 10% |
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What product do bacteria make bilirubin into bowel?
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urobilinogen
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Some urobilinogen is excreted in urine. what is the metabolite?
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urobilin
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Some urobilinogen is excreted in the feces. What form is it found in?
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urobilinogen is converted to stercobilinogen then to stercobilin which is excreted
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What process occurs to make stercoobilinogen into stercobilin?
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oxidation
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What is the normal plasma concentration of bilirubin in the blood?
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0.5-1mg/dL
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At what concentration will the skin become jaundice?
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3x normal so approximately 1.5-3mg/dL
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In hemolytic anemia what products of hemoglobin break down are elevated?
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free unconjugated bilirubin and urobilin in urine
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If a gallstone is obstructing the bile duct what hemoglobin metabolites would elevated or decreased?
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urobiln would be decreased because the bilirubin is not entering gi tract. conjugated bilirubin would be elevated in blood
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What test differentiates between unconjugated and conjugated biliburin?
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van den bergh reaction
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By looking at the stool of someone with cystic duct obstruction is it possible to tell by looking at their stool that they have an obstruction?
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yes their stool will be clay colored from a lack of stercobilin
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If a patient has juandice what is a way to determine if it is a severe obstruction?
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There will be excess unconjugated bilirubin in the urine. Simply shaking the urine will cause it foam because the unconjugated form is not normally soluble enough to be excreted but in high concentrations it can be. Also the urine will be an intense yellow
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